Can You Stay on Covered California After Age 65?

Reaching age 65 is a major milestone that opens up Medicare eligibility. So can you stay on your Covered California health plan after turning 65? In most cases, you will need to switch from Covered California to Medicare when you become eligible.

However, there are some exceptions that may allow you to keep Covered California coverage for a limited time after 65. Understanding the rules is key to transitioning properly and avoiding penalties.

Below we’ll explain when and how you can remain on a Covered California plan after age 65, and when you’ll need to switch to Medicare.

Overview of Covered California After 65

Here are some key things to know about staying on a Covered California plan after age 65:

  • You can keep Covered California with subsidies until you actually enroll in Medicare.

  • Once enrolled in Medicare, you’ll lose subsidies and likely need to drop Covered California.

  • Not signing up for Medicare at 65 can risk late enrollment penalties from Medicare.

  • Letting Medicare overlap with subsidized Covered California risks owing money to the IRS.

  • Notify Covered California immediately once you enroll in any part of Medicare.

  • Medigap and Medicare Advantage plans need to replace Covered California.

So in general, turning 65 means transitioning from Covered California to Medicare coverage. But you have some flexibility if you delay Medicare enrollment.

Keeping Covered California Until You Enroll in Medicare

You can remain on your Covered California plan past age 65 as long as you haven’t yet enrolled in Medicare. This grace period lets you maintain continuous health coverage before you formally transition to Medicare.

Here are some key points about keeping Covered California until Medicare enrollment:

  • You can keep receiving premium subsidies during this transition period.

  • No need to switch health plans if your doctor accepts both Covered California and Medicare.

  • Gives you continued coverage if delaying Part B enrollment until after 65.

  • Allows coordination time to settle Medicare effective dates and end Covered California.

So you aren’t forced to immediately drop Covered California on your 65th birthday. You have time to enroll in Medicare Parts A and B and coordinate the transition properly.

Losing Subsidies Once You Enroll in Medicare

While you can temporarily keep Covered California after 65, you’ll lose premium subsidies as soon as you enroll in any part of Medicare.

Medicare counts as minimum essential coverage under the Affordable Care Act. So if you’re eligible for premium-free Part A, you won’t qualify for subsidies after 65 regardless of actual Medicare enrollment.

Here are some key implications of losing Covered California subsidies after Medicare eligibility:

  • You pay 100% of the premium without subsidies.

  • Cost sharing rises significantly without cost-sharing reductions.

  • Spouses/dependents on the plan lose subsidies too.

  • Keeping subsidies past Medicare enrollment risks IRS liability.

So enrolling in Medicare makes Covered California coverage far more expensive for you. The loss of financial assistance makes staying on the plan difficult after gaining Medicare eligibility at 65.

Notifying Covered California About Medicare Enrollment

Once you enroll in any Medicare coverage, you must notify Covered California immediately to prevent financial issues.

Here are some key steps to take:

  • Report your Medicare Effective Date within 30 days of confirmation.

  • Call Covered California to terminate coverage or remove yourself from the plan.

  • End Covered California at least 14 days before Medicare begins.

  • Never have simultaneous Covered California subsidies and Medicare coverage.

Providing prompt notification ensures your Covered California coverage stops before Medicare starts to prevent overlap issues.

Transitioning to Medigap or Medicare Advantage

To fully transition from Covered California after 65, you’ll need to enroll in supplemental Medicare coverage:

  • Medigap: Helps pay Medicare cost sharing like copays and deductibles.

  • Medicare Advantage: Managed care alternative to Original Medicare. Often includes Part D.

  • Also consider adding standalone Part D drug coverage.

  • Must switch doctors/facilities to those accepting your Medicare coverage.

Having adequate Medicare supplemental coverage is essential for financial protection once you leave Covered California.

The Special Case of Premium Part A

If you need to pay premiums for Medicare Part A hospital coverage, you may be able to keep Covered California instead without subsidies.

Here are some key points on this scenario:

  • Only applies if you aren’t eligible for free premium Part A.

  • Can keep Covered California and subsidies without enrolling in Part A.

  • Weigh Covered California costs vs. Part A premiums.

  • Still need Part B at 65 to avoid lifelong penalties.

  • Can add optional Part D for drug coverage.

This exception lets you avoid expensive Part A premiums in favor of continuing Covered California. But you still need Part B, which has its own premium penalties if not taken at 65.

Strategies to Minimize Transition Disruption

Switching from Covered California to Medicare at 65 involves many moving pieces. Here are some tips to make the transition smooth:

  • Shop Medicare plans before turning 65 so coverage starts immediately.

  • Time Medicare enrollment so both coverages don’t overlap.

  • Check if your doctors take Medicare assignments or belong to Medicare Advantage plans.

  • Make sure any medications you take are covered under Medicare Part D or Advantage drug formularies.

  • Use the Medicare Plan Finder tool to identify options and estimated costs.

  • Consult with a Medicare counselor if you need help weighing options.

Planning ahead, understanding your Medicare options, and carefully coordinating enrollment dates are key to avoid gaps in care or financial issues.

The Takeaway

You can remain on your Covered California health plan past age 65 up until the point you enroll in Medicare. This gives you transition time to sign up for Medicare Parts A and B and supplemental coverage. But once you gain any Medicare coverage, you can no longer receive Covered California subsidies and will need to terminate your Covered California plan. With proper coordination, you can seamlessly transition around age 65 to maximize both Covered California and Medicare coverage as you become eligible.

Health Insurance Subsidy Repayment Even If You Left Covered California with Higher Income


Can I keep Covered California instead of Medicare?

You will no longer be eligible to receive financial assistance and your monthly premium and out-of-pocket cost may go up by a lot. However, if you have to pay a premium for Part A, you may keep your Covered California plan and receive financial help if eligible, instead of Medicare Part A – but not both.

Is there an age limit for Covered California?

People under age 26 can stay on a parent’s health plan. People under 30 have special options for health insurance. They can buy a minimum coverage health plan (also known as a catastrophic plan).

Who is not eligible for Covered California?

Who is Eligible for Covered California? All U.S. citizens, U.S. nationals and noncitizens lawfully present in California may apply for health care through Covered California. Who is Not Eligible for Covered California? If you are not lawfully present in California, you are not eligible for a Covered California plan.

What is the maximum income for Covered California 2023?

For 2023, your expected income is less than $20,385 as a single person, less than $27,465 for a household of two people, less than $34,545 for a household of three people, or less than $41,625 for a household of four people.

Leave a Comment